Increased creatinine kinase and rhabdomyolysis in anorexia nervosa

Walder, Alice; Baumann, Pierre

doi:10.1002/eat.20548

Cited by 9 publications

(8 citation statements)

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“…Indeed, excessive and compulsive exercising seems to play a significant role in the onset and maintenance of eating disorders [65], wherein it is usually used to control body weight and shape [66], but also to modulate mood [64]. It has been associated with increased risk of medical complications (e.g., overuse injuries, bone fractures, and cardiac complications) [67,68,69,70], higher rates of dropout from treatment programmes [71], longer inpatient treatment [72], poorer outcome [62], and quicker relapse [73]. It is also associated with greater severity of eating disorders [74] and general psychopathology, as well as specific personality features such as perfectionism and persistence [64].…”

Section: Resultsmentioning

confidence: 99%

Eating Disorders, Physical Fitness and Sport Performance: A Systematic Review

et al. 2013

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Background: Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. Methods/Design: A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles retrieved from PubMed had to be published in English between 1977 and 2013. Wherever possible, methods and reporting adhere to the guidelines outlined in the PRISMA statement. Some additional studies were retrieved from among those cited in the reference lists of included studies and from non-electronic databases. Literature searches, study selection, method and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Results: Of the 1183 articles retrieved, twenty-nine studies met the inclusion criteria and were consequently analysed. The available data indicate that eating disorders have a negative effect on physical fitness and sport performance by causing low energy availability, excessive loss of fat and lean mass, dehydration, and electrolyte disturbance. Discussion: Although the paucity of the available data mean that findings to date should be interpreted with caution, the information collated in this review has several practical implications. First, eating disorders have a negative effect on both physical fitness and sport performance. Second athletics coaches should be targeted for education about the risk factors of eating disorders, as deterioration in sport performance in athletes, particularly if they are underweight or show other signs of an eating disorder, may indicate the need for medical intervention. However, future studies are needed, especially to assess the direct effect of eating disorders on sport performance.

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Section: Resultsmentioning

confidence: 99%

Eating Disorders, Physical Fitness and Sport Performance: A Systematic Review

et al. 2013

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“…Hypokalemia is a known cause of rhabdomyolysis. There are some case reports of rhabdomyolysis in AN with [12] or without [13] acute renal failure. We suppose that dietary restriction and starvation, severe energetic deficit, chronic dehydration and metabolic derangement, especially hypophosphatemia and/or phosphate depletion, may induce chronic subclinical release of tissue catabolism products (CK, aldolase, AST, ALT, LDH, myoglobin) and chronic kidney injury.…”

Section: Discussionmentioning

confidence: 99%

Renal Involvement in Psychological Eating Disorders

2011

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Psychological eating disorders – anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder – are an increasing public health problem with severe clinical manifestations: hypothermia, hypotension, electrolyte imbalance, endocrine disorders and kidney failure; they are of interest to nephrologists, but pathophysiological mechanisms in determining the renal involvement are still unclear. We describe pathophysiology, histological features and clinical manifestations of the most frequent psychological eating disorders: AN and BN. Regarding AN, we analyze the recent literature, and identify 3 principal pathways towards renal involvement: chronic dehydration-hypokalemia, nephrocalcinosis and chronic rhabdomyolysis. Regarding BN, we describe the correlation between obesity and many proinflammatory cytokines, chemokines, growth factors and adipokines, having potential metabolic and hemodynamic effects on the kidney and an important role in the pathogenesis of obesity-related renal injury, independently of hypertension and diabetes.

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“…A MEDLINE search performed on November 19, 2009 showed three case reports of RM in association with anorexia nervosa [3][4][5], and one report of RM associated with BN [6]. This is the first case report of RM associated with nonpurging BN, and the first in an adolescent with BN.…”

Section: Discussionmentioning

confidence: 95%

“…This is usually termed "non-purging" BN [2]. Rhabdomyolysis (RM) has rarely been reported as a complication of eating disorders, usually with anorexia nervosa [3][4][5]. To date, only one case of RM in a person with BN has been reported, an adult woman with purging subtype and severe drug abuse [6].…”

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confidence: 99%